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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 1
INSIDE4 457 visas gone6 Decentralisation8 Indexation freeze hits
veterans10 World Congress of Public Health review13 AMA National
Conference preview18 Somalia’s cholera vaccinationsISSUE 29.08 MAY
1 2017
BUDGET TIMETime to farewell the freeze, p3
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2 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
Managing Editor: John Flannery
Editor: Chris Johnson
Contributors: Maria Hawthorne Meredith Horne Simon Tatz Alyce
Merritt
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Cover pic: AMA President Dr Michael Gannon and Health Minister
Greg Hunt in discussions ahead of the Budget.
National News 3-14
Health on the Hill 15
Research 16-17
World News 18-19
Member services 20
In this issue
AMA LEADERSHIP TEAM
Vice President Dr Tony Bartone
President Dr Michael Gannon
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 3
Hoping for a healthy BudgetThe Federal Budget will be handed
down by Treasurer Scott Morrison in Parliament House, Canberra on
Tuesday May 9.
The AMA will be searching the Budget’s contents to learn just
how the nation’s health budget will be impacted by the new fiscal
direction of the Government of Prime Minister Malcolm Turnbull.
Health Minister Greg Hunt has consulted extensively with the AMA
and is in no doubt of the issues important to doctors and patients
across Australia.
His language has been positive and there exists an apparent
goodwill and willingness to do the right thing in prioritising
health in the nation’s budget.
Just how persuasive Minister Hunt has been inside Cabinet, will
be seen once the Budget is handed down.
There have been good signs real progress will be made.
Unwinding the Medicare rebate freeze is one topic on which the
Minister has been sending positive messages.
“The Prime Minister has said and I have said that is an item
that we would be willing to review and we are willing to review
subject to a very clear set of reforms that will help make the
system stronger and better,” Mr Hunt has recently said.
This was welcomed by the AMA, but the extent of any thawing of
the freeze remains to be seen.
AMA President Michael Gannon said the Medicare rebate freeze,
which has been in place since 2010, having first been introduced by
the then Labor Government, had become a “barrier to reform” between
the health sector and the Coalition.
And he said ending the freeze wasn’t the only health policy and
funding issue the Government needs to address.
In the AMA’s Pre-Budget Submission, Dr Gannon argues that health
is the best investment the Government can make.
“The AMA agrees with and supports budget responsibility. But we
also believe that savings must be made in areas that do not
directly negatively affect the health and wellbeing of Australian
families,” Dr Gannon said.
“Health must be seen as an investment, not a cost or a Budget
saving.
“Any changes must be undertaken with close consultation with the
medical profession, and with close consideration of any impact on
patients, especially the most vulnerable – the poor, the elderly,
working families with young children, and the chronically ill.
“The Government must not make long-term cuts for short-term
gain. Patients will lose out.
“Primary care and prevention are areas where the Government can
and should make greater investment. General practice, in
particular, is cost-effective and proven to keep people well and
away from more expensive hospital care.
“The Government must also fulfill its responsibilities – along
with the States and Territories – to properly fund our public
hospitals. So too, the Government must deliver on its commitments
to improve the health of Indigenous Australians.”
In an apparent genuine Budget leak to News Corp newspapers,
Health reporter Sue Dunlevy suggested patients and taxpayers will
pay less for hundreds of medicines as a result of the Budget.
The Federal Government will look to secure $1.8 billion in
savings from big drug companies.
“However, many people will be pushed to switch to cheaper
generic versions of their medicines under reforms to save the
taxpayer money,” she wrote.
“And the price of X-rays and scans could rise with the
Government poised to abandon an election pledge to index the
Medicare rebates for these services.”
News Corp also revealed: (the points below are directly quoted
from the article.)
• The Medicare rebate for bulk billed GP visits will rise for
concession patients from July this year and from July 2018 for
general patients;
• The price of two of the most expensive medicines on the drug
subsidy scheme will be slashed by 25 per cent;
• Chemists will get taxpayer funding to compensate them for low
prescription volumes and $600 million for in pharmacy diabetes
checks;
• Pharmaceutical companies will suffer major price cuts for
hundreds of their medicines; and
• A 2014 plan to raise the price of prescription drugs by $5 is
expected to be abandoned.
Mr Hunt did not comment on the report except to say – through a
spokesman – that the Government’s goal was always to reduce the
cost of medicines for Australian patients, and that any claim about
restricting access to medicines was “completely false”.
Shadow Health Minister Catherine King said the reports suggested
the Government was attempting to pick and choose which parts of the
Medicare freeze to fix.
“If the Government’s six-year freeze on GPs, specialists’
consultations and procedures, and allied health professionals is
not immediately lifted on Budget night, it will be yet another blow
to our hard-working medical professionals and more evidence of how
little this Government listens,” she said.
CHRIS JOHNSON
NEWS
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4 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
NEWS
Welcome and concern for new visa system
The AMA has cautiously welcomed the Government’s new visa
arrangements while it waits for more information about the possible
impact of the changes on medical workforce shortages.
In a surprise announcement in April, Prime Minister Malcolm
Turnbull signalled the end of the current temporary skilled workers
visas regime.
The 457 visas will be abolished from March next year and
replaced with a new Temporary Skills Shortage Visa (TSS).
The new system will have tighter conditions and cater for a
smaller number of eligible occupations.
It will also be harder to progress to permanent residency from
the new visa class.
The AMA has been advised that doctors will still be eligible for
the new visa, but there is little detail about medical specialties
or groups.
Existing 457 visa holders will continue on the same conditions
they have now, but it is important that doctors with these visas
who have been working hard towards permanent residency are not
disadvantaged.
AMA President Dr Michael Gannon said international medical
graduates (IMGs) have made a huge contribution to the Australian
medical workforce, especially in rural areas and during periods of
chronic workforce shortages.
“Many communities would not have doctors if it were not for the
excellent work of IMGs,” Dr Gannon said.
“Australia is presently in the fortunate position of producing
sufficient locally-trained medical graduates to meet current and
predicted need.
“It is time to focus our energies on training the hundreds of
Australian medical graduates seeking specialist training.
“But we still need to have the flexibility to ensure that
under-supplied specialties and geographic locations can access
suitably-qualified IMGs when locally trained ones cannot be
recruited.”
Dr Gannon said it was important to strike the right balance
between filling vacancies with locally trained graduates and
ensuring communities, especially in rural and remote Australia,
have doctors in the right numbers and with the appropriate
specialist skills and experience to meet patient needs.
“The AMA welcomes the emphasis of the new arrangements to better
target recruitment and the mandatory requirement for
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 5
Welcome and concern for new visa system
NEWS
labour market testing, which the AMA has been calling for in
light of the significant increases in locally-trained medical
graduate numbers,” he said.
“We also need to see the Government step up policy efforts to
encourage local graduates to work in the areas and the specialties
where they are needed.
“We need to see flexibility in the arrangements, so for those
specialties or those areas of the workforce where genuine shortages
remain, that we are able to get staff from overseas.
“But what we’ve seen too much of is this mechanism gamed. We
need employers to be more honest about the needs for extra staff,
and what we need to see is greater investment in training positions
for those hundreds of locally trained doctors who are now lining up
desperately trying to find specialist training.
“And then deploy them where they’re needed, making sure that
Australians in rural and regional areas continue to be well
serviced by health professionals.”
The AMA is calling for a third of all medical students to come
from rural areas, and wants to see more positive experiences for
junior doctors and medical students when they go to the
regions.
“We know from evidence that that means they’re more likely to go
and work in the bush later,” Dr Gannon said.
“There’s a moral dimension to these changes. Every time
Australia recruits a doctor from a Third World country, or from
another country, they are taking those doctors away from
populations that desperately need them.
“Australia’s definitely reached self-sufficiency in terms of
total numbers of medical graduates.
“We’ve got to make sure that the public hospitals, the private
hospitals, the general practices, have the training positions so
that we can get Australian-trained doctors out there and
working.”
The Australian Medical Students’ Association (AMSA) also broadly
supports the Government’s new visa arrangements, but is concerned
the impact on international medical students graduating in
Australia has been overlooked.
AMSA is the peak representative body for Australia’s 17,000
medical students; 2,550 of which are international students from
USA, Canada, Singapore, Malaysia, UK and many other countries.
Under the new changes, international medical students wanting to
stay in Australia may be forced to take a gamble on their
career.
Following graduation, it will be a race against visa expiry to
enter specialty training in order to meet eligibility requirements
to stay in Australia.
The new TSS visa requires holders to have completed two years of
work experience, which graduates can complete on a 485 visa.
However, since Resident Medical Officers (RMOs) are only on the
short-term skilled occupational list (STSOL), graduates will only
have two to four years to begin their vocational training.
This timeline does not allow flexibility for unforeseen
circumstances. Further, the STSOL does not include a pathway into
permanent residency, leaving many international students uncertain
about the future.
Andreas Hendarto, an international medical student about to
graduate from University of Melbourne said the information received
was not yet complete, but he felt there was cause for concern.
“As a fresh graduate, I will have to apply for a short-term
two-year visa under the new scheme, ensuring that at the end of
that visa, I will have to renew it again for another two years and
hope that by the time that expires, I will be a registrar in a
medical specialty listed as eligible for the four-year
medium-to-long-term visa, which will allow me to stay in the
country – provided my specialty is still listed as part of the PR
skilled occupation list,” he said.
“If I fail at any stage of this process, I will receive no
reprieve.
“I had been looking forward to graduating and contributing back
to the Australian healthcare system, which kindly hosts and teaches
many international medical students for up to seven years.
“What then, can I do? I have spent the best part of eight years
in this country, and I look forward to spending many more.
“But this new TSS scheme means that after many more years of
working hard, I might still be forced to take my hard-earned
experience and knowledge in Australian health care elsewhere –
simply because I was here at the wrong time.”
CHRIS JOHNSON
... from p3
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6 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
Decentralisation push could hit health agenciesFederal Health
Department agencies could be relocated if the Government’s new push
for decentralisation gets momentum.
Health Minister Greg Hunt, along with Aged Care and Indigenous
Health Minister Ken Wyatt, may have to justify their department and
agencies remaining in the nation’s capital or offer up a business
case for suitable relocations.
The Nationals – the Coalition’s junior partner – are driving a
push to decentralise as many government departments as possible in
order to rejuvenate struggling regional centres.
Regional Development Minister Fiona Nash, who is also the Deputy
Nationals Leader, announced during a speech to the National Press
Club, that all Ministers would have to make the case for agencies
within their portfolios to remain in Canberra.
Criteria to make the assessments over what agencies to move
should be finalised mid-year, and Ministers will have until August
to report on which of their departments could be suitable for a
regional area.
They will have to provide solid reasons for claiming any agency
is not suitable for relocation.
Senator Nash said regional areas deserved the jobs opportunities
that decentralisation will offer.
She is supported in the push by Deputy Prime Minister and
Nationals Leader Barnaby Joyce, who is already relocating the
Australian Pesticides and Veterinary Medicines Authority to his own
electorate of Armidale in northern NSW.
But the Opposition has described the move as “trying to rip
apart the nation’s capital”.
“For a government which preaches efficiency and joined-up
government it is immensely hypocritical that they are pursuing a
policy that will make government more inefficient and more
fragmented,” said Labor MP Andrew Leigh whose electorate of Fenner
is in Canberra.
Gai Brodtmann, the Federal Member for Canberra, also condemned
the announcement.
“This is a blatant example of the Government’s complete and
utter disdain for Canberra,” she said.
“How long has the Government been hatching this secret plan to
essentially completely deconstruct Canberra, to deconstruct Sir
Robert Menzies’ legacy?”
The Labor MPs have been joined by their conservative
colleagues in the capital city, who say their own Government’s
push is misguided.
The ACT’s only federal Liberal, Senator Zed Seselja, said he was
“extremely disappointed” by the announcement.
“I have been on the record and made it very clear that I support
Canberra as the national capital and the centre of government,” he
said.
“If the Commonwealth wants to consider moving government
departments they should be moved from Sydney or Melbourne rather
than Canberra, which is a regional centre.
“The relocation of a small department like APVMA was difficult
enough and resulted in the loss of a large proportion of highly
trained specialist staff.”
The leader of the Liberals in the ACT Assembly, Territory
Opposition Leader Alistair Coe, said he too was concerned by the
push.
“Canberra was designed and created to be the capital of
Australia, and part of that capital means housing the public
service,” he said.
“There really do need to be exceptional circumstances for any
public service agency to be located outside of the ACT.”
ACT Chief Minister, Labor’s Andrew Barr, said the proposed
changes could benefit Canberra if the decentralisation meant
agencies located in NSW and Victoria were moved into the
capital.
“Around 62 per cent of all Australian Government employment is
located outside of the ACT,” Mr Barr said.
“So there is plenty of scope for the decentralisation agenda to
occur in the big states without undermining the core purpose of the
national capital or the effectiveness of public
administration.”
Canberra’s only daily newspaper, Fairfax’s Canberra Times,
responded with a front page headline screaming THE WAR ON CANBERRA
following the announcement.
While it is expected the Department of Health itself – currently
located in Canberra’s Woden precinct – is not a target, it is by no
means exempt from the push.
The relocation of some of its 17 operating portfolio agencies is
a real possibility.
CHRIS JOHNSON
NEWS
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 7
AMA President Dr Michael Gannon has gone public to clear the air
about the AMA’s position on pollution and climate change following
misinterpretation in some quarters of his comments about the
closure of the Hazelwood power plant in Victoria.
Dr Gannon strongly promoted the AMA’s long-held policies on
pollution and climate change and health, and raised the need to be
conscious of the health impacts of significant changes that affect
local communities and families.
He said that, as a responsible health advocate, he raised the
issue of care and concern for the people who lost their jobs
because of the Hazelwood closure, and the broader impacts on their
families and communities.
“I acknowledged the long-term effects of pollution in the
Latrobe Valley, and cited the work of doctors, led by Doctors for
the Environment Australia (DEA), in highlighting the health effects
of pollution in other incidents, including the Morwell fire in
2014,” Dr Gannon said.
“I raised the very real outcomes that stem from unemployment
such as mental health, loss of self-esteem, alcohol and drug
misuse, domestic violence, self-harm, suicide, and on it goes.
“These health effects are well documented in scientific studies
around the world.
“I believe that governments and industry must be aware of, and
make plans for, the impacts of transition – from employment to
unemployment, from old energy sources to new energy sources, and
for the ongoing impact of climate change on public health.
“It is a good thing for the AMA to responsibly point out the
health impacts and societal impacts on many levels, at varying
degrees, from situations like the Hazelwood closure. This is part
of our job as a leading and respected health advocate.
“AMA advocacy is very broad and very deep. It has to be. No
other medical or health organisation in the country can even come
close to initiating or influencing change across the health system
and society.
“We speak out on issues as diverse as workplace bullying and
harassment, Indigenous health, women’s health, men’s health, end of
life care, family and domestic violence, female genital mutilation,
concussion in sport, and firearms.
“These issues cover many facets of society and many
ideologies.
Some are regarded as progressive, some are conservative, but
most are controversial – and therefore potentially divisive.
“We do this on top of our other core business – Medicare, the
PBS, public hospital funding, the PSR, medical workforce, private
health, rural health, doctors’ health, and the broad range of
public health issues.
“The AMA has to always tread a fine line, and we do that
willingly. And so it is with contemporary issues like climate
change, pollution, air quality, and renewable energy.
“The AMA believes that climate change poses a significant
worldwide threat to health, and urgent action is required to reduce
this potential harm.
“We have been vocal about the need for urgent government action,
and have repeatedly called for the development of a National
Strategy for Health and Climate Change.
“The AMA Position Statement on Climate Change and Human Health
2015 is a very strong document. It was developed from the ground
up, with input from AMA members at grassroots level around the
country.
“The evidence is clear – we cannot sit back and do nothing,” Dr
Gannon said.
Dr Gannon urges AMA members and all doctors to visit the AMA
website to stay abreast of the AMA’s political advocacy and broad
policy agenda.
JOHN FLANNERY
NEWS
Clearing the air on pollution
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8 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
Indexation freeze hits veterans’ health careA recent survey of
some AMA members has highlighted the impact of the Government’s
ongoing indexation freeze on access to Department of Veterans’
Affairs (DVA) funded specialist services for veterans.
“The AMA conducted the survey following anecdotal feedback from
GP and other specialist members that veterans were facing
increasing barriers to accessing specialist medical care.”
The DVA Repatriation Medical Fee Schedule (RMFS) has been frozen
since 2012.
The AMA conducted the survey following anecdotal feedback from
GP and other specialist members that veterans were facing
increasing barriers to accessing specialist medical care.
Running between March 3 and 10, the survey was sent to AMA
specialist members (excluding general practice) across the
country.
It attracted interest from most specialties, although surgery,
medicine, anaesthesia, psychiatry and ophthalmology dominated the
responses.
More than 98 per cent of the 557 participants said they treat or
have treated veterans under DVA funded health care
arrangements.
For the small number of members who said they did not,
inadequate fees under the RMFS was nominated as the primary reason
for refusing to accept DVA cards.
When asked, 79 per cent of respondents said they considered
veteran patients generally had a higher level of co-morbidity or,
for other reasons, required more time, attention and effort than
other private patients.
According to the survey results, the indexation freeze is
clearly having an impact on access to care for veterans and this
will only get worse over time.
Table 1 highlights that only 71.3 per cent of specialists are
currently continuing to treat all veterans under the DVA RMFS, with
the remainder adopting a range of approaches including closing
their books to new DVA funded patients or treating some as fully
private or public patients.
Table 1
Which of the following statements best describes your response
to the Government’s freeze on fees for specialists providing
medical services to veterans under the Repatriation Medical Fee
Schedule (RMFS):
Answer Options Response Percent
I am continuing to treat all veterans under the RMFS 71.3%
I am continuing to treat existing patients under the RMFS, but
refuse to accept any more patients under the RMFS
9.9%
I am treating some veterans under the RMFS and the remainder
either as fully private patients or public patients depending on an
assessment of their circumstances
10.8%
I am providing some services to veterans under the RMFS (e.g.
consultations) but not others (e.g. procedures)
5.6%
I no longer treat any veterans under the RMFS 2.4%
NEWS
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 9
Indexation freeze hits veterans’ health care
If the indexation freeze continues, the survey confirmed that
the access to care for veterans with a DVA card will become even
more difficult.
Table 2 shows that less than 45 per cent of specialists will
continue to treat all veterans under the DVA RMFS while the
remainder will reconsider their participation, either dropping out
altogether or limiting the services provided to veterans under the
RMFS.
Table 2
Which of the following statements best describes your likely
response if the Government continues its freeze on fees for
specialists providing medical services to veterans under the
RMFS:
Answer Options Response Percent
I will continue to treat all veterans under the RMFS 43.8%
I will continue to treat existing patients under the RMFS, but
refuse to accept any more patients under the RMFS
15.5%
I will treat some veterans under the RMFS and the remainder
either as fully private patients or public patients depending on an
assessment of their circumstances
21.1%
I will provide some services to veterans under the RMFS (e.g.
consultations) but not others (e.g. procedures)
8.4%
I will no longer treat any veterans under the RMFS 11.2%
In 2006, a similar AMA survey found that 59 per cent of
specialists would continue to treat all veteran patients under the
RMFS.
There was significant pressure on DVA funded health care at the
time, with many examples of veterans being forced interstate to
seek treatment or being put on to public hospital waiting
lists.
The Government was forced to respond in late 2006 with a $600m
funding package to increase fees paid under the RMFS and, while the
AMA welcomed the package at the time, it warned that inadequate fee
indexation would quickly erode its value and undermine access to
care.
In this latest survey, this figure appears likely to fall to
43.8 per cent – underlining the AMA’s earlier warnings. The
continuation
of the indexation freeze puts a significant question mark over
the future viability of the DVA funding arrangements and the
continued access to quality specialist care for veterans.
The AMA continues to lobby strongly for the lifting of the
indexation freeze across the Medicare Benefits Schedule and the
RMFS, with these survey results provided to both DVA and the Health
Minister’s offices. The Government promotes the DVA health care
arrangements as providing eligible veterans with access to free
high quality health care and, if it is to keep this promise to the
veterans’ community, the AMA’s latest survey shows that it clearly
needs to address this issue with some urgency.
CHRIS JOHNSON
NEWS
... from page 8
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10 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
NEWS
Serious issues discussed at World Congress of Public HealthAn
array of brilliant and captivating speakers held centre stage at
the 15th World Congress of Public Health, discussing themes as
diverse as tobacco, alcohol and illicit drugs, obesity, and
maternal and infant health.
The AMA’s Public Health secretariat attended much of the
five-day Congress, which was held in Melbourne in April and which
brought together national and international experts across a wide
range of health areas.
The tobacco session canvassed policy levers to reduce
smoking-related mortality, specifying that the most effective way
to reduce tobacco consumption is through tobacco excise.
If you triple the price, consumption is halved and the tax yield
is doubled. A 100 per cent increase in tobacco excise would reduce
tobacco-related deaths by 20 per cent. We also heard about the
growth of tobacco plantations, many using child labour, and the
expansion of tobacco consumption in Asia.
Addressing obesity isn’t so straight forward. Preventing obesity
is complex and multi-layered, and it was said that single
behavioural change is not enough.
A panel of experts discussed numerous approaches to ending the
rise of obesity in a generation. One panellist posed the question:
Who should be leading the policy, prevention and treatment
agenda?
A somewhat controversial follow-up question was posed: Is health
the right field to lead the drive to end obesity?
The health and medical profession is tasked with addressing
obesity and the consequences of the high consumption of processed,
sugary and high-fat products (and lack of exercise). But shouldn’t
the initiative to prevent obesity be driven by communities,
families, workplaces, schools and those who are responsible for
obesity?
The health sector knows what to do – or at least we broadly
agree on most of the issues, factors, data, goals and targets – but
the gap is in the action. The highest rates of obesity are also in
the most disadvantaged quintile. This tells us where the problem is
most acute. It was argued that it is time for the agricultural
sector, food producers, primary industries, schools, wholesalers,
retailers, advertisers and media to be held accountable.
Discussion turned to the frustration the health sector
understands all too well – with so much evidence available
world-wide about obesity, why is there still a lack of policy
and legislative action? Australian governments have successfully
initiated and implemented measures to reduce tobacco consumption
(and sometimes alcohol and illicit drugs too) such as changing
price, behaviours and policy settings, but this isn’t being done
with obesity.
It was interesting to hear from several different presenters
that in relation to obesity, (and alcohol, tobacco and gambling)
self-regulation hasn’t worked. The message was told in different
ways but essentially it was the same; that industry ‘engagement’
has not achieved the desired outcomes, and allowing the makers of
foods and beverages, alcohol products, gambling or smoking
‘alternatives’ should not be involved in finding ‘solutions’.
Delegates heard that these ‘soft options’, such as industry
codes and industry-led campaigns, allow the makers and sellers (of
tobacco, junk food, sugar sweetened beverages, alcohol products,
gambling) to get away with proposals that favour their vested
interests.
In short, commercial entities in these areas are resisters to
good public health policies, legislation and stricter control.
These industries cannot be trusted to make changes for the public
good. Further, these industries seek to deflect, obfuscate and
influence governments and the public through their own ‘research’
and ‘engagement’.
The fact is, with all of these activities that are harmful and
cause injury, illness and premature death, it is the health system
that is left responsible for managing and caring for people. That’s
why many speakers argued that the true costs of these products
should be carried by the manufacturers, not the health system.
A sugar tax has been introduced (or about to be) in Ireland,
Mexico, Barbados, Chile, Hungry, UK, Philadelphia (USA) and some
Pacific Islands. Interesting, one speaker argued it wasn’t so much
about changing behaviour, but rather that sugar-sweetened beverages
are little more than water and chemicals and while the
manufacturers reap in huge profits, the true costs of consumption
are not reflected in the price.
The Congress was a very well organised event that showcased the
latest research, initiatives and policies that are improving our
knowledge and understanding of global public health.
• See also World News, p19
SIMON TATZ, DIRECTOR, PUBLIC HEALTH
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 11
Doctors best to give flu vaccines
The AMA has expressed concern that pharmacists will be able to
administer flu shots to adults this winter.
This is the first year pharmacists Australia-wide are allowed to
give the vaccinations, but the practice has been permitted in some
States and Territories for up to two years.
With winter and the 2017 flu season fast approaching,
pharmacists across Australia are preparing to administer the
vaccines to adults.
But AMA Vice President Tony Bartone said getting the jabs from a
local chemist was only a “second-best option”.
He said while it might seem convenient to duck into a pharmacy,
patients could lose out on vital consultations with their GPs.
“It is about ensuring the best possible standard of care is
applied rather than an acceptable or passable standard of care,” Dr
Bartone said.
“If there was an adverse reaction in the retail space, it would
be challenging at best and very problematic at worst.
“It is an extremely safe process, but we run the risk of
overlooking and over-simplifying something that does carry a very
low but inherent risk.”
Dr Bartone added that some patients, especially men, might
reduce regular visits to GPs if they can get their flu vaccinations
at pharmacies.
He also expressed concern at how cheaply some pharmacies
are offering the shots for (usually between $15 and $25, but as
low as $10 in some cases), suggesting it was part of a marketing
push by discount chain stores.
Anecdotal evidence suggests the cheaper the cost of the
vaccination, the less privacy the patient receives, with some
instances reported of pharmacists giving the shots on the shop
floor by the counter and in full view of other customers.
The better pharmacies provide private rooms and health
questionnaires before administering the shots.
They also have agreements with nearby medical centres in case of
difficulties such as adverse reactions.
Up to one in ten adults are infected by influenza annually,
while about three in ten children are infected.
It causes 1,500 to 3,500 deaths in Australia each year, usually
from direct viral effects such as viral pneumonia or complications
from secondary bacterial infections.
From 2016, the quadrivalent flu vaccine (QIV), which protects
against four strains of flu, became publicly available and
funded.
Prior to that, the trivalent vaccine (TIV), which protects
against three strains of flu, was the vaccine used in Australia for
many decades.
QIV and TIV were both available last year, but this year only
QIV is on offer.
The Australian Influenza Vaccine Committee reviewed data
relating to the flu strains circulating in Australia and the
Southern Hemisphere in the 2016 winter and subsequently made new
recommendations for vaccines.
They urged the Therapeutic Goods Administration to adopt the
World Health Organization recommendations for the strains to be
covered by the 2017 seasonal influenza vaccines.
While some health advocates support the wider availability of
and access to flu shots, all agree that nothing should replace
regular visits to the doctor.
CHRIS JOHNSON
NEWS
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12 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
NEWS
Local and world leaders in medical diagnosis will meet in
Melbourne in May to explore ways to improve diagnosis and patient
safety.
The theme of the 1st Australasian Diagnostic Error in Medicine
Conference is “teamwork and collaboration for safer diagnosis”, so
it will bring together GPs, radiologists, pathologists, emergency
department physicians and trainees, as well as nurses and other
allied health workers.
Joined by leaders in diagnostic error, the safety sciences,
health IT, medical indemnity providers, clinicians, cognitive
psychologists, and advocates for patients, the attendees share a
passion for making diagnosis more accurate, timely, and safe.
The language of diagnosis will be explored and the contribution
that medical culture makes to diagnostic error, both positive and
negative, will be examined.
The Conference is being held on 24-25 May (just before the AMA
National Conference 2017 on 26-28 May, also in Melbourne) and more
information can be found at
https://improvediagnosis.site-ym.com/page/AusDEM17
MARIA HAWTHORNE
1st Australasian Diagnostic Error in Medicine Conference
The troubled online Pharmaceutical Benefits Scheme (PBS)
authority approvals system is set for an overhaul, with the
Department of Human Services asking for input from doctors.
Launched last year, the system promised Authority approvals for
most PBS items online through Health Professional Online Services
(HPOS), without prescribers having to ring the Approvals phone
line.
However, the system turned out to be slow, clunky, and complex,
and its inability to interface with doctors’ desktop prescribing
software meant that it is virtually unused.
The Department has advised the AMA that it is keen to improve
the system, and is asking any doctor who prescribes PBS Authority
medicines to complete a quick six-question survey.
The information collected will help the Department work with the
medical software industry to develop products that allow access
through existing prescribing software.
You can access the survey here:
https://survey.websurveycreator.com/s.aspx?s=b38ea79f-050b-4563-b757-1e144f83f2c6
MARIA HAWTHORNE
Help improve online PBS authority approvals
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 13
NEWS
PM to address national conference The Wide World of Health –
Challenges, Threats, and Opportunities
Prime Minister Malcolm Turnbull will address the Saturday
morning session of the AMA National Conference, as the event’s
keynote speaker.
Don’t miss out on the opportunity to attend the 2017 AMA
National Conference at the Sofitel on Collins, Melbourne, from 26–
28 May, for a rare and unique glimpse into medico-politics, global
health issues and contentious contemporary health policies. The AMA
National Conference provides a platform for Australia’s leading
doctors to share their ideas on the way ahead for Australia’s
health system and to discuss themes and events in global
health.
This year’s Conference agenda features a number of sessions that
reach beyond the local horizon. We have a range of experts who will
be presenting and debating ‘big picture’ factors that influence our
health system and health systems around the world. These
include:
• Tackling Obesity – experts will present a range of
perspectives around the global obesity epidemic and possible
solutions, with a special focus on how AMA policy can help the
Government respond in a meaningful way.
• Threats Beyond Borders – an interactive panel discussion on
potential infectious diseases and threats that cross our borders,
and the possible role of a National Centre for Disease Control
(CDC) in Australia.
• Improving Australia’s organ donation rate – Australia is a
world leader in achieving successful organ transplant outcomes, but
our organ donation rate needs to increase to match world leaders.
This session will examine the ethical and practical considerations
related to Australia’s lagging organ donation rate.
• Doctors’ Health and Wellbeing – discuss initiatives and
examine current and emerging issues related to doctors’ health and
wellbeing, during medical training and in their professional
careers.
Dealing with Bad Health News Masterclass – Limited Places OnlyIn
conjunction with the 2017 AMA National Conference, the Pam McLean
Centre will provide a pre-conference masterclass open to all
doctors on Thursday 25 May, also held at the Sofitel on Collins,
Melbourne.
The masterclass on ‘Dealing with Bad Health News’ will be an
interactive, evidence based full-day masterclass designed to
provide a safe learning environment for participants to explore
different communication approaches to help patients deal with bad
health news.
Under the guidance of an expert facilitator, Professor Stewart
Dunn (Director, Pam McLean Centre), participants will develop
skills in interpreting human behaviour by improving the way they
recognise, identify and respond to emotional reactions.
This is an accredited activity for RACGP Category 1 and ACRRM
Core PDP points.
Pre-conference masterclass - details
• Time: 9:30 – 5:00 • Date: Thursday, May 25, 2017• Venue:
Sofitel, 25 Collins Street, Melbourne, VIC 3000• Tickets:
Conference attendees - $660, AMA members - $770,
non-AMA members - $880
For more information and Conference registration log onto:
https://natcon.ama.com.au/ or contact the Conference organisers at
[email protected].
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14 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
NEWS
INFORMATION FOR MEMBERS
Specialty Training Pathways Guide – AMA Career Advice
Service
With more than 64 different medical specialties to choose from
in Australia, making the decision to specialise in one can seem
daunting.
AMA members now have access to a new resource – one designed to
assist in making decisions about which specialty pathway to follow.
We know that concerns about length of training, cost of training
and work-life balance are important factors in making these
decisions, and information on the new site will help here too.
The absence of a comparative and definitive guide was raised by
our doctors in training and medical students.
Responding to this need from our doctors in training and medical
students, the AMA Career Advice Service has developed a
comprehensive guide to the specialties and sub-specialities which
can be trained for in Australia. The Guide will be updated annually
to reflect changes made by the Colleges, and the 2017 update will
be uploaded shortly.
The web-based Guide allows AMA members to compare up to five
specialty training options at one time.
Information on the new website includes:
• the College responsible for the training;
• an overview of the specialty;
• entry application requirements and key dates for
applications;
• cost and duration of training;
• number of positions nationally and the number of Fellows;
and
• gender breakdown of trainees and Fellows.
The major specialties are there as well as some of the lesser
known ones – in all, more than 64 specialties are available for
comparison and contrasting.
For example, general practice, general surgery and all the
surgical sub specialties, paediatrics, pathology and its sub
specialties, medical administration, oncology, obstetrics and
gynaecology, immunology and allergic medicine, addiction medicine,
neurology, dermatology and many, many more.
To find out more, visit www.ama.com.au/careers/pathway
This new addition to the Career Advice Service enhances the
services already available which include one-on-one career
coaching, CV templates and guides, interview skills “tips” and, of
course, a rich source of information available on the Career Advice
Hub: www.ama.com.au/careers
For further information and/or assistance, feel free to call the
AMA Career Advisers: Annette Lane and Christine Brill – 1300 133
665 or email: [email protected]
Please note current information within the guide relates to 2016
requirements. Information will be updated to reflect 2017
requirements soon.
Let the AMA’s Specialty Training Pathways guide help inform your
career decisions.
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 15
Health on the HillPOLITICAL NEWS FROM THE NATION’S CAPITAL
Close the Gap Parliamentary Friendship Group – an
observation
The AMA joined the inaugural meeting of the Close the Gap
Parliamentary Friendship Group, held on March 30 at Parliament
House.
Convened by Greens Senator Rachel Siewart, ALP Senator
Malarndirri McCarthy, and Liberal MP Lucy Wicks, the meeting aimed
to raise awareness among key decision makers about the scourge of
Rheumatic Heart Disease (RHD) on Aboriginal and Torres Strait
Islander peoples.
Worldwide, RHD affects more than 30 million people, with
Australia’s Aboriginal and Torres Strait Islander people having
among the highest rates of this debilitating disease.
The fact that RHD is occurring in Australia, and the fact that
we need to reinforce to our political leaders that they need to do
something about it, is symptomatic of consecutive government
failures to listen and act. RHD is a disease of poverty and it
should not be seen in Australia.
Yet Aboriginal and Torres Strait Islander people, particularly
children, continue to suffer from RHD every day. Penny, a young
patient advocate from Oenpelli in Arnhem Land, is one of those
children. Penny was diagnosed with RHD at around ten years of age,
and many of her family members are living with RHD as well – her
mother, uncle, aunty, and cousin. While it is unacceptable that RHD
is even occurring in Australia, it is intolerable that it is
affecting whole families.
RHD can be usually resolved if it is detected early, but people
are being treated for the condition when it is too late. Dr Bo
Remenyi, a paediatric cardiologist in the Northern Territory
described how she sees a new case of RHD being diagnosed among
Indigenous children every second day – this is about 150 new cases
per year.
RHD is no longer a public health problem in Australia. This
issue was solved for the majority of Australians about 50 or 60
years ago with the introduction of penicillin and better living
conditions. RHD is now a political problem.
In the words of Dr Remenyi: “We have a surgical solution for a
political problem. Australia needs a paradigm shift – we need to
move away from surgical solutions.” We need to invest in
prevention, and double the number of doctors and health workers on
the ground – Aboriginal and Torres Strait Islander communities have
the smallest health workforce in Australia. This is highly
disproportionate, particularly when the health needs of Aboriginal
and Torres Strait Islander people are two to three times higher
than their non-Indigenous peers.
Part of the solution to addressing RHD is educating members of
the community about skin infections, and how they can lead to Acute
Rheumatic Fever, and then to RHD if they are not quickly treated.
But most of all, there needs to be a strong will to put RHD in the
history books.
The community, health professionals, people working
laboratories, public servants and most of all, governments, are all
responsible for helping to make this a reality. Our political
leaders need to show leadership and take action to work with health
professionals and communities to rid Australia of RHD.
ALYCE MERRITT, INDIGENOUS POLICY ADVISER AMA
INFORMATION FOR MEMBERS
Essential GP tools at the click of a button
The AMA Council of General Practice has developed a resource
that brings together in one place all the forms, guidelines,
practice tools, information and resources used by general
practitioners in their daily work.
The GP Desktop Practice Support Toolkit, which is free to
members, has links to around 300 commonly used administrative and
diagnostic tools, saving GPs time spent fishing around trying to
locate them.
The Toolkit can be downloaded from the AMA website
(http://ama.com.au/node/7733) to a GP’s desktop computer as a
separate file, and is not linked to vendor-specific practice
management software.
The Toolkit is divided into five categories, presented as easy
to use tabs, including:• online practice tools that can be
accessed and/or completed online;• checklists and questionnaires
in PDF
format, available for printing;• commonly used forms in
printable
PDF format;• clinical and administrative
guidelines; and • information and other resources.
In addition, there is a State/Territory tab, with information
and forms specific to each jurisdiction, such as WorkCover and S8
prescribing.
The information and links in the Toolkit will be regularly
updated, and its scope will be expanded as new information and
resources become available.
Members are invited to suggest additional information, tools and
resources to be added to the Toolkit. Please send suggestions,
including any links, to [email protected]
HEALTH ON THE HILL
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16 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
RESEARCH
Domestic violence leading cause for women and girls hospitalised
from assault
New data released by the Australian Institute of Health and
Welfare (AIHW) shows that nearly 6,500 women and girls were
hospitalised due to assault in Australia in 2013–14, with the
violence usually perpetrated by a partner or spouse.
The statistics on the deaths and serious injuries resulting from
family and domestic violence has been called a national epidemic,
and one of Australia’s biggest social, legal and health
problems.
The AIHW examined cases of hospitalised assault against women
during that period and it exposed that when place of occurrence was
specified, 69 per cent of assaults against women and girls took
place in the home.
“While women and girls are, overall, hospitalised as the result
of assault at a rate that is less than half the equivalent rate for
men (56 cases per 100,000 females compared to 121 cases per 100,000
males), the patterns of injury seen for females are different to
that seen for males.” AIHW spokesperson Professor James Harrison
said.
AIHW data highlights:
• Nearly 60 per cent of hospitalised assaults against women and
girls were perpetrated by a spouse or domestic partner.
• More than half (59 per cent or 3,685) of all women and girls
hospitalised due to assault were victims of an assault by bodily
force and a further quarter of all hospitalised assault cases
against women and girls involved a blunt (17 per cent or 1,048
cases) or sharp object (9 per cent or 551 cases).
• Open wounds (22 per cent or 1,400 cases), fractures (22 per
cent or 1,375) and superficial injuries (19 per cent or
1,194) accounted for almost two-thirds of the types of assault
injuries sustained by women and girls.
• In the 15 years and older age group, 8 per cent of victims
were pregnant at the time of the assault.
The AIHW notes that the data used in their report probably
underestimates the incidence of hospitalised assault resulting from
domestic violence, as victims can be reluctant to report an
incident to hospital personnel or to identify a perpetrator for
hospital records.
The AMA believes the medical profession has key roles to play in
early detection, intervention and provision of specialised
treatment of those who suffer the consequences of family and
domestic violence, whether it be physical, sexual or emotional.
Further the AMA advocates that medical practitioners must
encourage attitudes and actions necessary to prevent family and
domestic violence, identify women, men, families and children ‘at
risk’, prevent further violence and assist patients to receive
appropriate help and protection.
If you or someone you know is impacted by sexual assault or
family violence, call 1800RESPECT on 1800 737 732 or visit
www.1800RESPECT.org.au In an emergency, call 000.
MEREDITH HORNE
Liver research links genetics to treatmentThe discovery by
scientists at Sydney’s Westmead Institute for Medical Research that
the interferon lambda 3 (INLF3) protein causes liver fibrosis, has
brought hope for the developments of new liver disease
treatments.
The research also revealed a strong link between a patient’s
inherited genetic makeup and the amount of liver damage to improve
techniques of identifying patients at risk of developing cirrhosis,
and the development of new drug targets.
Currently liver transplantation is the only treatment for liver
failure. No current treatments are available for a safe
pharmacological therapy that prevent the progression of liver
disease.
The lead author of the study, Professor Jacob George, says that
the research will enable early interventions and lifestyle changes
because it helps to predict risk of liver disease to
individuals.
The Westmead Institute has developed a diagnostic tool based on
their discoveries, which is available for all doctors to use, to
aid in predicting liver fibrosis risk.
Research
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 17
“This test will help to determine whether an individual is at
high risk of developing liver fibrosis, or whether a patient’s
liver disease will progress rapidly or slowly, based on their
genetic makeup,” Professor George said.
Liver disease is now the fifth most common cause of death in
Australia and affects 6 million Australians. Most forms of liver
disease significantly increase the risk of liver cancer, which is
the most rapidly increasing form of cancer worldwide.
Australia is a world leader for successful transplant outcomes
with almost 3,000 Australian adults and children have undergone
successful liver transplantation. However there are still many more
people requiring transplants than donors.
MEREDITH HORNE
Mapping HIV virus for more effective treatmentDeakin University
scientists, with support from CSIRO, have revealed for the first
time the individual protein blocks that form the HIV virus.
It is hoped that the research will enable the development of
effective and affordable new antivirals to treat millions of people
living with HIV.
The exact way the virus formed had eluded scientist for the past
30 years so that current antivirals created only a partial
understanding of how the pieces joined together.
“Inadequate supply of anti-HIV drugs in low- and middle-income
countries has created an ideal breeding ground for the emergence of
drug resistant HIV, which threatens the long-term effectiveness of
patient care using existing anti-HIV agents,” said senior
researcher Professor Johnson Mak, from Deakin University’s Centre
for Molecular and Medical Research.
Professor Mak hoped his team’s work would go on to inform the
development of new drugs that work by interfering with the
formation of infectious virus particles – essentially blocking HIV
from taking a hold on patients.
HIV continues to be a major global public health issue. UNAIDs
estimates in 2015, an estimated 36.7 million people were living
with HIV, there were 2.1 million new infections worldwide and in
the same year 1.1 million people died of AIDS-related
illnesses.
The AMA this year launched its updated position statement on
blood borne viruses (BBVs). The statement expressed the AMA’s
support for the availability of new, regularly evaluated treatments
for BBVs.
Further, it acknowledged that prevention, treatment, and
management of BBVs is a public health priority that requires a
coordinated and strategic policy response, with national leadership
driving actions to sustain improvements in their prevention,
detection, and treatment. A copy of the statement can be found at:
https://ama.com.au/position-statement/blood-borne-viruses-bbvs-2017
MEREDITH HORNE
UHT milk used to study age-related diseases A new study on UHT
milk jointly undertaken by ANU, CSIRO, University of Wollongong and
international researchers is helping scientists to better
understand Alzheimer’s, Parkinson’s and type 2 diabetes – opening
the door to improved treatments for these age-related diseases.
The research examined how milk proteins changed structurally
when heated briefly to around 140 degrees to produce UHT milk,
causing the gelling phenomenon with long-term storage.
These proteins are the same type of protein clusters found in
plaque deposits in cases of Alzheimer’s and Parkinson’s.
Fifty different diseases have been recognised as being
associated with protein aggregation.
“Parkinson’s, dementia and type 2 diabetes are big problems for
the ageing population in Australia and many other countries around
the world,” said Professor John Carver from the ANU Research School
of Chemistry.
“Any means we can understand these proteins, their structure and
why they form amyloid fibrils has the potential for developing
treatments.”
Aging relating diseases affect about 500 million people
worldwide and is set to increase over the next 20 to 30 years.
Population projections by the Australian Treasury forecasts the
number of Australians aged 65 is increasing rapidly, from 2.5
million in 2002 to 6.2 million in 2042, or from 13 per cent of the
population to 25 per cent.
The collaborative research was published in the published in the
journal Small. The research does not suggest UHT milk can cause
these age-related diseases.
MEREDITH HORNE
Research ... from page 15
RESEARCH
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18 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
WORLD NEWS
Cholera vaccination campaign focussing on Somalia
A second stage of a major vaccination campaign to halt the
spread of cholera got underway in March and April in three
drought-ravaged regions of Somalia.
Gavi, the Vaccine Alliance, delivered 953,000 doses of Oral
Cholera Vaccine to the country to protect more than 450,000 people
from the disease.
The campaign took place in three of the worst-hit regions,
Banadir, Kismayo and Beledweyne, with the vaccine being given in
two doses to everyone over the age of one. The first round ran from
15-19 March and the second from 18-22 April.
The vaccines were procured, transported and stored at the
appropriate temperature by UNICEF. They are being administered by
the Government of Somalia with the support of World Health
Organisation (WHO) and UNICEF; while UNICEF and others continue to
improve water and sanitation infrastructure and promote behaviour
change. As well as providing the vaccines, Gavi has provided
US$550,000 to support the campaign.
Seth Berkley, CEO of Gavi, said the people of Somalia are going
through unimaginable suffering.
“After years of conflict, a severe drought has brought the
country to the brink of famine and now a suspected cholera outbreak
threatens to become a nationwide epidemic,” he said.
“These lifesaving vaccines will play a vital role in slowing the
spread of the disease, buying valuable time to put the right
water, sanitation and hygiene infrastructure in place to stop
the root causes of this outbreak.”
Dr Ghulam Popal, WHO Representative in Somalia, said cholera was
a major health issue in Somalia.
“The current drought has worsened the situation for many.
Therefore we’re very glad to have the support of Gavi to implement
the first OCV campaign in Somalia,” Dr Popal said.
“We are very hopeful that the vaccination campaign will control
outbreaks, and eventually save lives.”
The current severe drought in Somalia has forced communities to
use contaminated water, helping cholera to spread. A total of
25,000 cases of Acute Watery Diarrhoea/cholera have been reported
since the beginning of 2017, causing at least 524 deaths.
Surveillance reports indicate that the epidemic is now spreading to
areas inaccessible to aid workers.
UNICEF Somalia Representative, Steven Lauwerier said the
vaccination campaign was an emergency measure.
“We need to continue to tackle the main cause of such
outbreaks,” he said.
“UNICEF, donors, government and other stakeholders are making
some progress in improving access to safe water and promoting good
sanitation and hygiene practices and this needs to be scaled up
urgently.”
Women wait to have themselves and their children vaccinated
against cholera at the Banadir hospital in Mogadishu, Somalia.
Gavi, with funding from the government of Australia, has shipped
nearly a million doses to support the campaign. Photo/Karel
Prinsloo/Arete/Gavi
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AUSTRALIAN MEDICINE - 29.08 MAY 1 2017 19
Cholera vaccination campaign focussing on Somalia
International spotlight on Indigenous public health equity
Gavi, the Vaccine Alliance is a public-private partnership
committed to saving children’s lives and protecting people’s health
by increasing equitable use of vaccines in lower-income
countries.
The Vaccine Alliance brings together developing country and
donor governments, the World Health Organization, UNICEF, the World
Bank, the vaccine industry, technical agencies, civil society, the
Bill & Melinda Gates Foundation and other private sector
partners.
Gavi uses innovative finance mechanisms, including co-financing
by recipient countries, to secure sustainable funding and adequate
supply of quality vaccines. Since 2000, Gavi has contributed to the
immunisation of nearly 580 million children and the prevention of
approximately 8 million future deaths.
CHRIS JOHNSON
Prominent Maori health advocate Adrian Te Patu led a yarning
circle at the 15th World Congress of Public Health, which
unanimously supported the establishment of an Indigenous Working
Group within the World Federation of Public Health
Associations.
Mr Te Patu is the first Indigenous representative on the WFPHA
Governing Council and is well-known throughout is homeland New
Zealand and internationally for his campaigning on health
issues.
He will now formalise the Indigenous Working Group, following
its acceptance at the World Congress, which was held in Melbourne
in April.
The Indigenous Working Group will provide an opportunity to
bring to the global public health and civil society arena a visible
and prominent Indigenous voice that privileges an Indigenous world
view and narrative.
“We intend to create a platform for change with the aim to
address the health inequities experience by Indigenous peoples
worldwide,” Mr Te Patu said.
The group was formed on the 50th anniversary of the WFPHA, at
the 15th World Congress conference, when 40 Indigenous and
non-Indigenous conference delegates of the yarning circle
unanimously supported in principle its establishment.
The Public Health Association of Australia hosted the yarning
circle that was led by Mr Te Patu.
A yarning circle, also known as a dialogue circle, comes from
the traditional Aboriginal process of discussing issues in an
inclusive and collaborative manner.
All participants are invited to have their say in a
non-judgemental environment.
The WFPHA’s function and mandate includes its link into the
global health governance mechanisms such as the World Health
Organisation.
CHRIS JOHNSON
WORLD NEWS
... from page 18
The oral cholera vaccine is taken in two doses a month apart,
and offers protection against the disease for the majority of
people who take it. Gavi, with funding from the government of
Australia, has shipped nearly a million doses to support the
campaign. Photo/Karel Prinsloo/Arete/Gavi
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20 AUSTRALIAN MEDICINE - 29.08 MAY 1 2017
MUSICNEWS NEWSMOTORINGNEWSNEWSNEWSMOTORING
AMA members can access a range of free and discounted products
and services through their AMA membership. To access these
benefits, log in at www.ama.com.au/member-benefits
AMA members requiring assistance can call AMA member services
on
1300 133 655 or [email protected]
Jobs Board: Whether you’re seeking a new position, looking to
expand your professional career, or looking to recruit staff to
your practice, doctorportal Jobs can help you. Discounts apply for
AMA members. jobs.doctorportal.com.au
MJA Events: AMA members are entitled to discounts on the
registration cost for MJA CPD Events!
UpToDate: UpToDate is the clinical decision support resource
medical practitioners trust for reliable clinical answers. AMA
members are entitled to discounts on the full and trainee
subscription rates.
doctorportal Learning: AMA members can access a state of the art
CPD tracker that allows CPD documentation uploads, provides
guidance CPD requirements for medical colleges, can track points
against almost any specialty and provides access to 24/7
mobile-friendly, medical learning.
Learning.doctorportal.com.au
MJA Journal: The Medical Journal of Australia is Australia’s
leading peer-reviewed general medical journal and is a FREE benefit
for AMA members.
Fees & Services List: A free resource for AMA members. The
AMA list of Medical Services and Fees assists professionals in
determining their fees and provides an important reference for
those in medical practice.
Career Advice Service and Resource Hub: This should be your
“go-to” for expert advice, support and guidance to help you
navigate through your medical career. Get professional tips on
interview skills, CV building, reviews and more - all designed to
give you the competitive edge to reach your career goals.
www.ama.com.au/careers
Amex: As an AMA member, receive no-fee and heavily discounted
fee cards including free flights and travel insurance with range of
Amex cards.*
Mentone Educational: AMA members receive a 10% discount on all
Mentone Educational products, including high quality anatomical
charts, models and training equipment.
Volkswagen: AMA members are entitled to a discount off the
retail price of new Volkswagen vehicles. Take advantage of this
offer that could save you thousands of dollars.
AMP: AMA members are entitled to discounts on home loans with
AMP.
Hertz: AMA members have access to discounted rates both in
Australia and throughout international locations.
Hertz 24/7: NEW! Exclusive to the AMA. AMA members can take
advantage of a $50 credit when renting with Hertz 24/7.
Qantas Club: AMA members are entitled to significantly reduced
joining and annual fees for the Qantas Club.
Virgin Lounge: AMA members are entitled to significantly reduced
joining and annual fees for the Virgin Lounge.
MJA Bookshop: AMA members receive a 10% discount on all medical
texts at the MJA Bookshop.
AMA Member Benefits